Provider Demographics
NPI:1346976974
Name:JR PHYSICAL THERAPY
Entity Type:Organization
Organization Name:JR PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNHO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-289-7807
Mailing Address - Street 1:210 RIVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5215
Mailing Address - Country:US
Mailing Address - Phone:201-289-7807
Mailing Address - Fax:
Practice Address - Street 1:17 BRINKERHOFF TER # 200
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1101
Practice Address - Country:US
Practice Address - Phone:201-313-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty